氯诺昔康超前镇痛对乳腺癌根治术后疼痛的影响

Efficacy of Lornoxicam for Preemptive Analgesia after Radical Mastectomy Surgery

  • 摘要: 目的:研究使用氯诺昔康对乳腺癌根治术行超前镇痛的效果及合理用药剂量。方法:选择乳腺癌根治术90例,随机分为A、B、C 三组,每组30例。A 组于术前30min静注氯诺昔康8mg,B 组于术前30min静注氯诺昔康16mg,C 组于术前30min静注0.9%NaCl 液10mL。均于术后2、4、8、24h 各时段对患者进行疼痛数字分级法评分(NRS ),并记录术后恶心、呕吐、头晕、嗜睡、瘙痒、尿潴留等不良反应以及术后镇痛药使用情况。结果:A、B 组患者术后2、4、8、24h 各时段的NRS 显著低于C 组(P<0.05),A、B两组比较,B 组的NRS 在术后2、4、8h 三时段显著低于A 组(P<0.05),B 组的NRS 在术后24h 虽较A 组低,但无统计学意义(P>0.05);A、B 两组术后24h 内需使用镇痛药的人数明显少于C 组(P<0.05),但A、B 两组间无统计学意义;三组患者术后不良反应发生率无统计学差异。结论:对乳癌根治术患者预先使用氯诺昔康可以达到良好的超前镇痛目的,可减少术后镇痛药的使用,较少不良反应的发生,使用16mg氯诺昔康的镇痛效果较佳。

     

    Abstract: Objective: To investigate the effects of lornoxicam for preemptive analgesia in patients undergoing radical mastectomy and to determine optimal dosage. Methods:Ninety adult patients (ASA I~II), scheduled for radical mastectomy surgery, were randomly divided into 3 groups ( n=30, each group). Group A consisted of patients who received intravenous infusions of 8mg lornoxicam 30minutes before surgery, Group B consisted of patients who received intravenous infusions of 16mg lornoxicam before surgery, and Group C consisted of patients who were administered10ml9% normal saline in-travenously 30minutes before surgery. Postoperative analgesia efficacy was assessed by a numerical rating scale (NRS) at 2, 4, 8, and 24hours after surgery, adverse effects (such as nausea, vomiting, dizziness, hypersomnia, pruritus and uros -chesis, etc.) and requests for analgesia were recorded. Results: The NRS was significantly lower in group A and B than in group C (P<0.05) at 2, 4, 8, and 24hours after surgery, and it was significantly lower in group B than in group A (P<0.05) at 2, 4, and 8 hours after surgery. The total number of cases that requested analgesia during 24hours in group A and B was fewer than in group C ( P<0.05). There was no significant difference in adverse effects after surgery among the 3 groups. Conclusion:Preemptive analgesia with lornoxicam exhibits good analgesic effect in patients undergoing radical mastectomy and reduces the dosage of analgesia and adverse effects. Administration of 16mg lornoxicam for preemptive analgesia can achieve satisfactory efficacy for postoperative analgesia.

     

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